Acceptance and commitment therapy as guided self-help for psychological distress and positive mental health: a randomized controlled trial

2011 ◽  
Vol 42 (3) ◽  
pp. 485-495 ◽  
Author(s):  
M. Fledderus ◽  
E. T. Bohlmeijer ◽  
M. E. Pieterse ◽  
K. M. G. Schreurs
Keyword(s):  
Mental Health ◽  
Acceptance And Commitment Therapy ◽  
Experiential Avoidance ◽  
Depressive Symptomatology ◽  
Positive Mental Health ◽  
The Self ◽  
Experimental Conditions ◽  
Self Help ◽  
Acceptance And Commitment

BackgroundIn order to reduce the high prevalence of depression, early interventions for people at risk of depression are warranted. This study evaluated the effectiveness of an early guided self-help programme based on acceptance and commitment therapy (ACT) for reducing depressive symptomatology.MethodParticipants with mild to moderate depressive symptomatology were recruited from the general population and randomized to the self-help programme with extensive email support (n=125), the self-help programme with minimal email support (n=125) or to a waiting list control group (n=126). Participants completed measures before and after the intervention to assess depression, anxiety, fatigue, experiential avoidance, positive mental health and mindfulness. Participants in the experimental conditions also completed these measures at a 3-month follow-up.ResultsIn the experimental conditions significant reductions in depression, anxiety, fatigue, experiential avoidance and improvements in positive mental health and mindfulness were found, compared with the waiting list condition (effect sizes Cohen's d=0.51–1.00). These effects were sustained at the 3-month follow-up. There were no significant differences between the experimental conditions on the outcome measures.ConclusionsThe ACT-based self-help programme with minimal email support is effective for people with mild to moderate depressive symptomatology.

Behavioral Activation and Acceptance and Commitment Therapy in the Treatment of Anxiety and Depression in Cancer Survivors: A Randomized Clinical Trial

2020 ◽  
pp. 014544552091644
Author(s):  
Concepción Fernández-Rodríguez ◽  
Sonia González-Fernández ◽  
Rocío Coto-Lesmes ◽  
Ignacio Pedrosa
Keyword(s):  
Cancer Survivors ◽  
Acceptance And Commitment Therapy ◽  
Experiential Avoidance ◽  
Behavioral Activation ◽  
Emotional Problems ◽  
Post Treatment ◽  
Behavioural Activation ◽  
Commitment Therapy ◽  
Acceptance And Commitment

Behavioural Activation (BA) and Acceptance and Commitment Therapy (ACT) aim to reduce the inflexible avoidance of painful thoughts, feelings and memories and to encourage involvement in relevant activities, objectives which are clearly relevant to the situation of cancer survivors with emotional problems. With a view to evaluating and comparing the efficacy of both therapies, applied on a group basis, a randomized controlled trial was developed. Cancer survivors (age 18–65 years) with anxiety and/or depression were assigned at random to two experimental groups (BA; ACT) and a waiting list control group (WL). Of the 66 cancer survivors randomized to trial (intention-to-treat sample), 46 participants ( M = 51.49; SD = 6.88) completed the intervention (BA, n = 17; ACT, n = 12; WL, n = 17) (per-protocol sample). The emotional state, experiential avoidance and behavioural activation of the participants was evaluated in the pre- and post-treatment and in a 3-month follow-up using standardized instruments. Both treatment groups showed statistically significant changes, indicating an improvement in all the result variables in the post-treatment and follow-up as compared to the pre-treatment. BA showed better results than ACT regarding impact on anxiety and activation. This greater efficacy may have been due to factors such as the emphasis placed in BA on behavioural activation and the central role played in it by functional analysis. The key role played by experiential avoidance and behavioral activation in the maintenance and treatment of emotional problems in cancer survivors is discussed. Raw data are available online ( http://dx.doi.org/10.17632/m7w688khs8.1 )

Examining the Feasibility of Acceptance and Commitment Therapy Self-Help for Problematic Pornography Viewing

2017 ◽  
Vol 25 (4) ◽  
pp. 306-312
Author(s):  
Michael E. Levin ◽  
Scott T. Heninger ◽  
Benjamin G. Pierce ◽  
Michael P. Twohig
Keyword(s):  
Acceptance And Commitment Therapy ◽  
Intervention Period ◽  
Cognitive Fusion ◽  
Psychological Inflexibility ◽  
Self Help ◽  
Commitment Therapy ◽  
Acceptance And Commitment ◽  
Seeking Help ◽  
Trial Participants

This pilot study evaluated the feasibility of an acceptance and commitment therapy (ACT) self-help program for problematic pornography viewing (PV). A sample of 19 adults seeking help for problematic PV was recruited in an open trial. Participants reported adequate program acceptability, although only 45% of those completing postassessment read at least half of the self-help book. Significant improvements on problematic PV and cognitive fusion were found over the 8-week intervention period, with effects sustaining at 8-week follow-up. Participants who read more improved more on PV problems and psychological inflexibility. Overall, an ACT self-help approach appears feasible and potentially efficacious for PV.

A self-help based Acceptance and Commitment Therapy programme using Internet delivery: effect on adults intending to work who have utilized their sick leave due to depressive symptoms

2017 ◽  
Vol 5 (4) ◽  
pp. 462
Author(s):  
Maki Tei-Tominaga
Keyword(s):  
Depressive Symptoms ◽  
Sick Leave ◽  
Acceptance And Commitment Therapy ◽  
Psychological Flexibility ◽  
The Self ◽  
Secondary Outcome ◽  
Self Help ◽  
Commitment Therapy ◽  
Acceptance And Commitment ◽  
Internet Delivery

Rationale: The aim of this study was to develop a self-help based Acceptance and Commitment Therapy (ACT) programme using Internet delivery, which can be practised at the workplace or at home and to examine its effect on adults intending to work who have utilized their sick leave due to depressive symptoms. Method: A one-group, baseline-to-post-intervention design was utilized with participants in Japan. Among the participants (N = 35), 26 completed the self-help based programme and answered all questionnaire surveys on 3 occasions: baseline (T1), after 3 weeks (T2) and after 6 weeks when the programme ended (T3). As the primary outcome, depressive symptoms were assessed using the Zung Self-Rating Depression Scale. As the secondary outcome, psychological flexibility was assessed using the Japanese version of the revised Acceptance and Action Questionnaire. Additionally, 3 items to assess process were administered and participants’ written comments were organized by content.Results: Although the number of participants who showed mild and moderate depressed states decreased, depressive symptom scores did not significantly change over time. Psychological flexibility at T3 significantly improved compared to baseline, while the effect size was relatively low (Cohen’s d = 0.35). One of the scores from the process measures showed a significant difference between T2 and T3. There were 5 positive and 5 negative comments. Conclusions: Along with participants’ comments, the findings suggested the effectiveness of the self-help based ACT programme using Internet delivery. This has the potential to help develop mindfulness and acceptance skills in adults who are intending to return to work after taking sick leave for depressive symptoms.

scholarly journals Acceptance and Commitment Therapy (ACT) Improves Sleep Quality, Experiential Avoidance, and Emotion Regulation in Individuals with Insomnia—Results from a Randomized Interventional Study

Life ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 133
Author(s):  
Ali Zakiei ◽  
Habibolah Khazaie ◽  
Masoumeh Rostampour ◽  
Sakari Lemola ◽  
Maryam Esmaeili ◽  
...  
Keyword(s):  
Emotion Regulation ◽  
Sleep Quality ◽  
Acceptance And Commitment Therapy ◽  
Experiential Avoidance ◽  
Dysfunctional Beliefs ◽  
Acceptance And Commitment ◽  
Sleep Log ◽  
Weekly Group ◽  
Beliefs And Attitudes

Insomnia is a common problem in the general population. To treat insomnia, medication therapies and insomnia-related cognitive-behavioral interventions are often applied. The aim of the present study was to investigate the influence of acceptance and commitment therapy (ACT) on sleep quality, dysfunctional sleep beliefs and attitudes, experiential avoidance, and acceptance of sleep problems in individuals with insomnia, compared to a control condition. A total of 35 participants with diagnosed insomnia (mean age: 41.46 years old; 62.9% females) were randomly assigned to the ACT intervention (weekly group therapy for 60–70 min) or to the active control condition (weekly group meetings for 60–70 min without interventional and psychotherapeutic character). At baseline and after eight weeks (end of the study), and again 12 weeks later at follow-up, participants completed self-rating questionnaires on sleep quality, dysfunctional beliefs and attitudes about sleep, emotion regulation, and experiential avoidance. Furthermore, participants in the intervention condition kept a weekly sleep log for eight consecutive weeks (micro-analysis). Every morning, participants completed the daily sleep log, which consisted of items regarding subjective sleep duration, sleep quality, and the feeling of being restored. Sleep quality, dysfunctional beliefs and attitudes towards sleep, emotion regulation, and experiential avoidance improved over time, but only in the ACT condition compared to the control condition. Improvements remained stable until follow-up. Improvements in experiential avoidance were related to a favorable change in sleep and cognitive-emotional processing. Micro-analyses showed that improvements occurred within the first three weeks of treatment. The pattern of results suggests that ACT appeared to have improved experiential avoidance, which in turn improved both sleep quality and sleep-related cognitive-emotional processes at longer-term in adults with insomnia.

scholarly journals Development and Evaluation of Acceptance and Commitment Therapy Delivered by Psychologists and Non-Psychologists in an NHS Community Adult Mental Health Service: a Preliminary Analysis

2017 ◽  
Vol 46 (1) ◽  
pp. 121-127
Author(s):  
Thomas Richardson ◽  
Lorraine Bell ◽  
Helen Bolderston ◽  
Sue Clarke
Keyword(s):  
Mental Health ◽  
Mental Health Service ◽  
Health Service ◽  
Acceptance And Commitment Therapy ◽  
Preliminary Evaluation ◽  
Community Mental Health Service ◽  
Commitment Therapy ◽  
Acceptance And Commitment ◽  
Post Therapy

Background: Previous studies have demonstrated that acceptance and commitment therapy (ACT) is effective for depression and may be useful for complex transdiagnostic clients. Aims: To conduct a preliminary evaluation of whether ACT is feasible and effective when delivered by psychologists and non-psychologists for complex clients in a National Health Service (NHS) community mental health service for adults. Method: Staff were trained in ACT and conducted one-to-one therapy with clients. Measures on general mental health, depression, fusion and values were given pre-therapy, post-therapy and at 3-month follow-up. Results: Standardized measures showed significant improvements post-therapy for global mental health, depression, cognitive fusion and values post-treatment. These were partially maintained at follow-up and remained after an intent-to-treat analysis. There were no differences in outcomes between psychologists and non-psychologists. Conclusions: ACT may be delivered effectively with limited training for complex cases in secondary care, though further research is needed.

scholarly journals One year follow-up and mediation in Cognitive Behavioral Therapy and Acceptance and Commitment Therapy for adult depression

2019 ◽  
Author(s):  
Jacqueline G.L. A-Tjak ◽  
Nexhmedin Morina ◽  
Maurice Topper ◽  
Paul M.G. Emmelkamp
Keyword(s):  
Quality Of Life ◽  
Depressive Symptoms ◽  
Cognitive Behavioral Therapy ◽  
Acceptance And Commitment Therapy ◽  
Experiential Avoidance ◽  
Behavioral Therapy ◽  
Dysfunctional Attitudes ◽  
Acceptance And Commitment

Abstract Background Existing therapies for depression are effective, but many patients fail to recover or relapse. To improve care for patients, more research into the effectiveness and working mechanisms of treatments is needed. We examined the long-term efficacy of Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT) for Major Depressive Disorder (MDD), testing the hypothesis that CBT outperforms ACT and that both therapies work through their designated mechanisms of change. Methods We conducted a randomized controlled trial with 82 patients suffering from MDD. Data were collected before, during and after treatment, and at 12-month follow-up, assessing symptoms of depression, quality of life, dysfunctional attitudes, decentering , and experiential avoidance. Results Patients in both conditions reported significant and large reductions of depressive symptoms ( d = -1.26 to -1.60) and improvement in quality of life ( d = 0.91 to -1.28) 12 months following treatment. Our findings indicated no significant differences between the two interventions. Dysfunctional attitudes and decentering mediated treatment effects of depressive symptoms in both CBT and ACT, whereas experiential avoidance mediated treatment effects in ACT only. Conclusions Our results indicate that CBT is not more effective in treating depression than ACT. Both treatments seem to work through changes in dysfunctional attitudes and decentering, even though the treatments differ substantially. Change in experiential avoidance as an underlying mechanism seems to be an ACT-specific process. Further research is needed to investigate whether ACT and CBT may work differently for different groups of patients with depression.

scholarly journals One year follow-up and mediation in Cognitive Behavioral Therapy and Acceptance and Commitment Therapy for adult depression

2020 ◽  
Author(s):  
Jacqueline G.L. A-Tjak ◽  
Nexhmedin Morina ◽  
Maurice Topper ◽  
Paul M.G. Emmelkamp
Keyword(s):  
Quality Of Life ◽  
Depressive Symptoms ◽  
Cognitive Behavioral Therapy ◽  
Acceptance And Commitment Therapy ◽  
Experiential Avoidance ◽  
Behavioral Therapy ◽  
Dysfunctional Attitudes ◽  
Acceptance And Commitment

Abstract Background Existing therapies for depression are effective, but many patients fail to recover or relapse. To improve care for patients, more research into the effectiveness and working mechanisms of treatments is needed. We examined the long-term efficacy of Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT) for Major Depressive Disorder (MDD), testing the hypothesis that CBT outperforms ACT and that both therapies work through their designated mechanisms of change.Methods We conducted a randomized controlled trial with 82 patients suffering from MDD. Data were collected before, during and after treatment, and at 12-month follow-up, assessing symptoms of depression, quality of life, dysfunctional attitudes, decentering , and experiential avoidance.Results Patients in both conditions reported significant and large reductions of depressive symptoms (d = -1.26 to -1.60) and improvement in quality of life (d = 0.91 to -1.28) 12 months following treatment. Our findings indicated no significant differences between the two interventions. Dysfunctional attitudes and decentering mediated treatment effects of depressive symptoms in both CBT and ACT, whereas experiential avoidance mediated treatment effects in ACT only. Conclusions Our results indicate that CBT is not more effective in treating depression than ACT. Both treatments seem to work through changes in dysfunctional attitudes and decentering, even though the treatments differ substantially. Change in experiential avoidance as an underlying mechanism seems to be an ACT-specific process. Further research is needed to investigate whether ACT and CBT may work differently for different groups of patients with depression.

scholarly journals One year follow-up and mediation in Cognitive Behavioral Therapy and Acceptance and Commitment Therapy for adult depression

2020 ◽  
Author(s):  
Jacqueline G.L. A-Tjak ◽  
Nexhmedin Morina ◽  
Maurice Topper ◽  
Paul M.G. Emmelkamp
Keyword(s):  
Quality Of Life ◽  
Depressive Symptoms ◽  
Cognitive Behavioral Therapy ◽  
Acceptance And Commitment Therapy ◽  
Experiential Avoidance ◽  
Behavioral Therapy ◽  
Dysfunctional Attitudes ◽  
Acceptance And Commitment

Abstract Background Existing therapies for depression are effective, but many patients fail to recover or relapse. To improve care for patients, more research into the effectiveness and working mechanisms of treatments is needed. We examined the long-term efficacy of Cognitive Behavioral Therapy (CBT) and Acceptance and Commitment Therapy (ACT) for Major Depressive Disorder (MDD), testing the hypothesis that CBT outperforms ACT and that both therapies work through their designated mechanisms of change.Methods We conducted a randomized controlled trial with 82 patients suffering from MDD. Data were collected before, during and after treatment, and at 12-month follow-up, assessing symptoms of depression, quality of life, dysfunctional attitudes, decentering , and experiential avoidance.Results Patients in both conditions reported significant and large reductions of depressive symptoms (d = -1.26 to -1.60) and improvement in quality of life (d = 0.91 to -1.28) 12 months following treatment. Our findings indicated no significant differences between the two interventions. Dysfunctional attitudes and decentering mediated treatment effects of depressive symptoms in both CBT and ACT, whereas experiential avoidance mediated treatment effects in ACT only. Conclusions Our results indicate that CBT is not more effective in treating depression than ACT. Both treatments seem to work through changes in dysfunctional attitudes and decentering, even though the treatments differ substantially. Change in experiential avoidance as an underlying mechanism seems to be an ACT-specific process. Further research is needed to investigate whether ACT and CBT may work differently for different groups of patients with depression.Trial registration clinicaltrials.gov; NCT01517503. Registered 25 January 2012 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT01517503?term=NCT01517503&rank=1

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